The NHS: What’s the damage?

After working in the NHS for some time, I have grown to love and respect this great national institution that is all-too-often shunned and shamed by the mainstream media. It seems all we ever hear are bad news stories, and none of the good ones – with a fatalistic projected future, many of the people who use the NHS have cause to be concerned for its survival.

Let’s start with the good news. The NHS is one of the biggest employers in the country, and continues to train and fund its medical staff under the NHS grant system. It also researches more and more into cures for both mental and physical health issues. Whenever we become sick, we can rest assured, safe in the knowledge that we can be seen by an emergency department, GP or even NHS direct without worrying about incurring any costs. Credit where credit’s due, after all.

We must beware of putting our feet up too early, however. There are certain flaws in the system that have the potential to threaten the NHS’ vital services to the public.

The first of these is chronic understaffing, across the board – from doctors and nurses, to IT staff, to admin staff and even lowly temporary staff like me. Because of cuts to funding and inefficient use of public money, the NHS cannot afford to employ enough staff to keep the system ticking along at a reasonable rate. This means all its staff are stressed and stretched to the absolute limit, with many departments and hospitals running weeks behind schedule. This would be extremely bad for business in the private sector, but because this is the NHS, people’s health and even patients’ lives are at risk.

The next, and particular problem to the current era, would be Britain’s aging population. After the Second World War, when many soldiers returned home and rationing was stopped, a new era of prosperity was ushered in. The NHS was set up in 1946, to deal with the fact hundreds of thousands of working-class people were dying because they could not afford medical treatment. Lord Beveridge described his intentions for “cradle to grave” healthcare, an incredibly well-meaning and innovative statement. Nowadays, quite frankly, the grave is approaching for those born in this period of prosperity, and extra care and funding is required for the influx of elderly people. In some ways, the NHS has been the creator of its own demise – if, back in the 1940’s and 1950’s, the war had ended and a health service was set up, it probably seemed a good time to start a family, hence the “baby boom”. As infant mortality was lower, many more of these infants grew to become adults, and now they are older they require more specialist and frequent care.

This leads us on to the next problem for the NHS – the obesity crisis and poor lifestyle choices. This point has been hammered so hard by the media that we largely forget about the other issues, but it is still massively important nonetheless. When the NHS was set up in 1946, prosperity meant more people had time off work to go out and enjoy fresh air and other outdoor activities, though not enough money to eat out or to buy a television set. As our economy has developed, our lives have become more advanced, but only in the sense that we have a greater range and availability of expensive foods, consumer goods, cigarettes and alcohol. I hate harking back to a time when things were ‘simpler’ (usually meaning worse for women, ethnic minorities and working-class people), but I think in this instance there is something to be said for less takeaway food, smoking and drinking, and more nutritious food and active leisure pursuits.

On the bright side, though, there are many people who zealously support the NHS and believe strongly in keeping it afloat – none more so than its staff. In my experience there is a certain camaraderie seldom found in private-sector companies, a spirit of “we’re all in this together” and a feeling of working towards the national good, keeping the system going etc. Karl Marx once said that the worker was alienated from their labour and thus the end product of their labour, but I’m not sure this is true in the NHS – most are acutely aware that their actions would affect patient treatment and thus their lives, right down to the people in my low pay grade, who do not have any contact with patients.

So what is to be done about this difficult state of affairs? Firstly – the system must be kept going until the aging population begins to decline. After that, the strain on the NHS may lessen enough for there to be a restructuring of it, designed to better deal with a large and concentrated population like that of the UK. Secondly, anyone who supports the NHS must vocalise their opinion and ensure the government knows the majority of people will not tolerate further cuts to vital services such as this. Lastly, something everyone can do is to make healthier lifestyle choices – in many ways this nips the problem in the bud and stops it from becoming completely unmanageable. Maybe this way we will finally start hearing some good news stories about our National Health Service.

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2 responses to “The NHS: What’s the damage?”

This article woefully underestimates the financial catastrophe that the NHS is heading towards. The health service is a privilege and a blessing but it is heading to insolvency. The current situation, the range of services that are free at the point of use, the sheer size of the organisation, are completely unsustainable in its current form. You have not taken into consideration the state of the nation’s finances, a 1.5 trillion debt and a 100 billion deficit along with a horribly unbalanced economy means one thing; we are broke, stone broke, bankrupt. A whole manner of things are used to pretend that this is not in fact the case, but it is indeed the reality. Proper reform, or cross party proposals, are politically impossible, so all parties will propose pumping money into the NHS until it verges on total collapse or we simply cannot afford to do so anymore. Its horrifying but true.

I see nothing wrong with having a passion for something that is for the most part good. Yes, it’s true that politicians throw money at it, and that has always been the case. But that said, that is what the electorate wants. Given a choice on what our taxpayers dollars are spent on, health will always trump any other area of expenditure. So whilst there are grave financial problems now, it has to be remembered that there always were – even dating back to when the NHS was founded. The NHS was founded in a time of post war austerity. Yes, we are broke (but not any more so than usual), but health spending will, and should always take priority.

There are no simple fixes, and I don’t believe the article tries to pretend there are. I know people who work for the NHS. One of the problems alluded to is that the NHS (when management is not busy wasting money hand-over-fist) will prioritise money in areas politicians think will reap them brownie points, such as doctors and nurses to the detriment of all else, Yes, you need doctors and nurses, but you also need backroom staff to book appointments, communicate between patients, GP’s other disciplines within the NHS in complex cases, yet these are the people they will cut back on, but without them the service grinds to a halt. However there are no brownie points for spending money on backroom staff.

For me, the solutions lie in taking the politics out of health. As the political will of governments flip flop between extremes, so the NHS has to follow according to the current short term politics. But the problem is, can you really have no (or little) political control over something that consumes so much public money? No simple solutions.

In terms of what can be realistically done, the biggest problem is grossly incompetent management, and too much of it. Start there!